Uterine Fibroid Embolization

    Uterine Fibroids and Their Symptoms

Fibroids are benign, non-cancerous growths in or on the walls of the uterus, or womb. They can range from less than an inch around to more than six inches. Women with a family history are more likely to develop fibroids.

Most fibroids cause no symptoms, and are only discovered when a woman has a routine pelvic examination.

If you do experience fibroid symptoms, they may include:

• Heavy, prolonged monthly periods, sometimes with clots
• Anemia (fatigue due to low red blood count)
• Pain or pressure between the hip bones or in the back of the legs
• Pain during sexual intercourse
• Frequent need to urinate
• Constipation or bloating
• An enlarged belly

If you suspect you have fibroids, your doctor should conduct an ultrasound or other imaging tests to be certain.

If you do not have symptoms, treatment is probably unnecessary. Your doctor may want to continue to monitor your fibroids. If you do have symptoms, several options are available.

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Medical Treatments

Birth control pills can often decrease heavy bleeding. Other hormone treatments can shrink fibroids, but these treatments may cause menopause-like side effects such as hot flashes and bone loss. Fibroid symptoms usually return when medical treatment stops.

Surgical Treatments

Surgical treatment options include hysterectomy, which is the removal of the uterus, and myomectomy, removal of just the fibroids. While these options are generally effective, they require anesthesia and lengthy recovery times and carry a risk of surgical complications. Many women are not candidates for myomectomy procedures because of the size, number, or location of their fibroids.

Uterine Fibroid Embolization

Uterine Fibroid Embolization, or UFE, is a minimally invasive option that preserves the uterus and greatly reduces recovery times compared to surgical procedures. UFE is performed by an Interventional Radiologist (IR), a doctor who uses x-rays and other imaging techniques to see inside the body and treat conditions without surgery.

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UFE blocks the blood supply to fibroids, causing them to shrink. It is clinically proven to reduce the major symptoms of fibroids, including pain, excessive and prolonged bleeding, and frequent urination. UFE is minimally invasive, requiring only a small nick in the skin. The procedure lasts less than an hour, and patients return to work in an average of 11 days.

During UFE, you are given sedation medication but remain awake. The Interventional Radiologist inserts a thin tube into an artery at the top of your thigh, then uses x-ray imaging to guide the tube to the uterine artery. Tiny round particles called Emboshpere® Microspheres† are injected into the blood vessels that lead to the fibroids. They block blood flow, causing the fibroids to shrink. Embosphere Microspheres remain at the fibroid site permanently. The process is repeated in your other uterine artery for complete blockage of blood to the fibroid.

Benefits of UFE*

				UFE				Hysterectomy
Shorter Hospital Stay				< one day				2.3 days
Return to Work Faster				10.7 days				32.5 days
Fewer Complications (after 30 days)				12.7%				32%

Patient Satisfaction with UFE

In clinical stucies conducted at 11 medical centers in the United States, 132 women with fibroid problems were treated with Embosphere Microspheres. After 12 months, the majority had significant improvements in menstrual bleeding, pelvic pain, pelvic discomfort, and frequency of urination. Ninety percent reported being satisfied. Recent long-term reports demonstrate a 73% resolution rate five years after UFE. These results are equal to or better than five-year results after myomectomy.

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Is UFE Right for You?

If you need treatment for fibroid symptoms but want to avoid surgery, UFE may be right for you. Your gynecologist can provide a referral to an Interventional Radiologist who can help you decide based on your medical history and the size and location of your fibroids.

Patients who are ideal for UFE include women who:

• Have symptomatic fibroids
• Do not intend to get pregnant in the future
• Want to keep their uterus
• Do not want surgery
• Want an overnight or outpatient hospital stay
• May not be good candidates for surgery

You should not have this procedure if you are pregnant or want to become pregnant. The effects of UFE on the ability to become pregnant and carry a fetus to term, and on the development of the fetus, have not been determined.

While there are reports of women becoming pregnant after UFE and having successful pregnancies, there are no scientific study results establishing the safety of UFE on fertility and pregnancy. As with any medical intervention, you should discuss the most current clinical data before deciding on the fibroid treatment option that is right for you.

Most insurance companies cover UFE as a treatment for symptomatic fibroids. Discuss your coverage with your doctor or insurance provider before the procedure.

Overall, UFE is a safe procedure for treating symptomatic fibroids with minimal risk. Infrequent complications have been reported following UFE. The most reported risk factors and complications associated with UFE are transient amenorrhea, common short-term allergic reaction/rash, vaginal discharge/infection, possible fibroid passage, and postembolization syndrome. The most common complications associated with hysterectomy are vaginitis, drug reactions, and urinary tract infections, with some more serious complications reported after 30 days incuding pneumonia, bowel injury, vaginal cuff herniation, and recurrent bleeding from the vaginal stump.

You should talk with your doctor about the risks associated with UFE. For more information please call San Diego Imaging at (858) 634-5900 or visit www.sandiegoimaging.com.

Questions to Ask

Talk with Your Interventional Radiologist

• Are your patients happy with UFE?
• How often is the procedure successful?
• How will you coordinate care with my gynecologist?
• What are typical complications and how often do they occur?
• How will I feel during and after the procedure?
• How long should I expect to be off work?
• How long should I expect to stay in the hospital?
• What kind of follow-up care is typical and who manages it?
• Will my insurance cover the procedure?